Incontinence rates are reported as high as 60% for residents in nursing homes and 66% for patients in acute care. Intensive care units generally have the highest incontinence rates. Skin injuries due to incontinent-associated dermatitis (IAD) occur in a third of hospitalized patients. As many as 41% of adults in long-term care facilities experience some form of skin condition in the perineal region. IAD increases the risk of microbial skin infections and pressure ulcers, which can lead to longer hospital stays, increased treatment cost, greater risk of nosocomial infection, and higher morbidity and mortality rates. The reason for the incontinence is often unknown. In some cases, incontinence may be caused by multiple factors including treatments which cannot be discontinued in hospitalized patients.
Moreover, skin conditions are a metric of an acute care facility's quality. When applying to the American Nurses Association for Magnet Status, an acute care facility must report quarterly data on pressure ulcer prevalence. Similarly, long-term care facilities must report pressure ulcer rates and risk fines if proper actions were not taken to prevent the injuries
Managing incontinence according to the Guidelines of the Wound, Ostomy, and Continence Nurses Society requires the skin be kept dry and clean and the application of skin protectant after each incontinent episode. Delays in changing a brief or diaper are cited as the leading cause of IAD, while more frequent changing of incontinence briefs was found to reduce the incidence of pressure ulcers.
However, without a method to identify when an incontinent event has occurred, caregivers are often unaware of the patient's condition. As a result perineal hygiene occurs most often by schedule rather than by need.